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Migrants travelling to their country of origin: a bridge population for HIV transmission?
  1. Merlijn A. Kramer (mkramer{at}
  1. GGD Amsterdam, Netherlands
    1. Maaike G. van Veen (maaike.van.veen{at}
    1. RIVM, Netherlands
      1. Eline L.M. Op de Coul ({at}
      1. RIVM, Netherlands
        1. Ronald B. Geskus (rgeskus{at}
        1. GGD Amsterdam, Netherlands
          1. Roel A. Coutinho (roel.coutinho{at}
          1. RIVM, Netherlands
            1. Marita J.W. van de Laar ({at}
            1. RIVM, Netherlands
              1. Maria Prins (mprins{at}
              1. GGD Amsterdam, Netherlands


                Background: By having unprotected heterosexual contacts in both the Netherlands and their homeland, migrants who travel to their homeland might form a bridge population for HIV and STI transmission. We studied the determinants for such a population in two large migrant communities in the Netherlands.

                Methods: From 2003-2005, 1938 persons of Surinamese and Antillean origin were recruited at social venues in two large cities, interviewed, and saliva samples were tested for HIV antibodies. We used multivariate multinomial logistic regression to explore characteristics of groups with four risk levels (no, low, moderate, and high) for cross-border transmission.

                Results: 1159/1938 (60%) participants had travelled from the Netherlands to their homeland in the previous 5 years and 1092 (94%) of them reported partnerships and condom use in both countries. Of these, 9.2% reported having unprotected sex with partners in both countries. Persons in this high-risk or bridge population were more likely to be male, frequent travellers, and older compared to persons who had no sex or had sexual contact solely in one country in the past 5 years.

                Conclusions: Older male travellers of Surinamese and Antillean origin are at high risk for cross-border heterosexual transmission of HIV/STIs. They should be targeted by prevention programs, which are focused on sexual health education and HIV/STI testing, to raise their risk awareness and prevent transmission.

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